Abstract: Kidney diseases are accompanied by a number of secondary metabolic dysregulations, such as lipid abnormalities, presenting with unique characteristics. An increased risk of cardiovascular disease, independent of conventional risk factors, is present even at minor levels of renal impairment and is highest in patients with endstage renal disease (ESRD). Although proprotein convertase subtilisin／kexin 9 (PCSK9) modulates cholesterol metabolism by regulating LDL receptor expression in the liver, in vitro and in vivo studies have suggested that PCSK9 is involved in various other physiological processes. Increasing number of studies investigate the possible association of PCSK9 levels with proteinuria, hypercholesterolaemia, kidney function, renal fibrosis, as well as its role as a prognostic cardiovascular risk marker in CKD. Clinical trials of PCSK9 inhibitors have revealed clinically meaningful effects in CKD. In this review, we discuss the existing evidence for the role of PCSK9 in patient groups with nondialysis CKD, ESRD and kidney transplantation.

Key words: proprotein convertase subtilisin／kexin 9, kidney diseases, lipid metabolism, cardiovascular disease event